“Leafy, middle” areas of England are falling behind some of the most deprived parts of the country in improving quality of life, new research by one of the world’s leading experts on public health suggests.

Analysis by Sir Michael Marmot, an authority on the effects of inequality on health, shows that while some of the poorest neighbourhoods have seen signifucant progress in recent years, other seemingly comfortable areas have effectively stagnated.

Middle class families are still under “extreme” pressure to make ends meet despite the economic recovery, warned Sir Michael, president of the World Medical Association and director of the Institute of Health Equity at University College London (UCL).

Sir Michael Marmot

Crucially, he said, children in some middle class families are falling behind the richer counterparts because their parents have less time to read to them or even give them hugs because of the pressures of working to maintain a basic standard of living and cope with soaring housing costs.

“It is really important not to think only about the lot of the poor but to think of everybody below the top.”

Sir Michael Marmot

He calculated that 200,000 people a year – or 550 people a day – die prematurely in the UK because of a health gap between a small elite and the rest.

As part of an annual review of inequality and health, Sir Michael compared key indicators of overall quality of life in England over the last few years.

It highlights how, while unemployment has been falling, almost one in four families could not afford a basic acceptable standard of livingin 2013 – a section of society which grew by a fifth in four years.

Pointing to rises in work-related illness and differences in the number of years people live in good health, it concludes that the fruits of economic recovery are not being felt across society.

But, significantly, Sir Michael said the figures underline the importance of being concerned not only with “the lot of the poor” but that of “everybody below the top”.

And the study contrasts significant improvements on some measures, especially education, in poor, inner city areas with other areas considered to be more affluent which had seen little if any improvement recently.

“The disadvantage of being in the middle compared with being at the top persists,” he said.

“And I think it relates to not quite having all the money you need to do all the things you that think is important; not quite having the kind of work that you need to fulfil your aims and dreams; I think it relates to more difficulties with housing costs, in general not having all those things.

“We see that children in the middle, not just those at the bottom, do less well in terms of early child development at age five and GCSE performance than children at the top.

“So it starts at the beginning of life, with early childhood development, and with education, work, income, housing it continues right through life.”

He added: “To the extent that the areas you’re describing are leafy, middle areas, they are not immune from what’s going on.”

The report cites figures showing that pupils in Hackney, east London, often quoted as one of the most deprived boroughs in England, outperformed the national average last year with 64.9 per cent getting five or more good GCSEs. That compares, for example, with 60.7 per cent in Bath, Somerset.

And while the gap in the share of Hackney pupils on free school meals and the average across the borough was only 4.2 percentage points, in Bath it was 33 points.

Similarly it shows how the proportion of pupils in Tower Hamlets in east London getting five good GCSEs rose from just under 46 per cent in 2009 to almost 60 per cent in 2014 while the proportion in York only increased slightly from just over 59 per cent to just over 62 per cent in the same period.

Tower Hamlets: associated with deprivation Photo: FRANTZESCO KANGARIS

A similar pattern can be seen on a regional level with key indicators such as youth unemployment, fuel poverty and some income measures deteriorating in the wealthier South East of England but improving in the less prosperous North West.

“This is not to say that the South East is worse than the North ?. but the advantage of the South East has diminished.”

Sir Michael Marmot

“This is not to say that the South East is worse than the North …. but the advantage of the South East has diminished because they are worse on those three measures,” he said.

He said the inequality not just between rich and poor but between the rich and those in the middle can be seen early in life in studies such as those comparing how often adults read or play with three-year-olds.

“What we also know is that parents’ social and economic situation impacts on their ability to do these normal parenting activities,” he said.

“So being in the middle is not as good as being in the top 20 per cent in terms of the impact, it is just harder.”